It was dark by the time members of the East Village walkabout group entered Tompkins Square Park, carrying plastic bags containing clean syringes, sterilized cookers and tourniquets, condoms, lubricants and dental dams.
Within minutes, the group encountered a gaunt heroin addict with a large crucifix dangling down his T-shirt. He seemed eager to exchange needles with Tom Smith, director of overdose prevention programs for the Lower East Side Harm Reduction Center.
The addict gave coded information to Smith: the first two letters of his last name, the first letter of his mother’s first name and the complete date of his birth. Soon after he left with a plastic bag, an older man – a deaf mute – approached the group with a hesitant smile. One of the volunteers helped conduct the syringe exchange in sign language.
Two decades ago, this exchange would’ve been illegal. But in the early ’90s, during the height of the AIDS pandemic, New York state laws prohibiting the possession and distribution of hypodermic needles were loosened to allow for Syringe Exchange Programs (SEPs).
In 1992, the LES Harm Reduction Center was one of only four New York agencies authorized to conduct needle exchanges. These days, besides leading walkabouts in the East Village and the Union Square area, the center hosts transactions from its headquarters at 25 Allen Street. Though it has long had clearance to conduct walkabouts in a three-block radius of the meatpacking district – at one point a hotspot for drug-using transgender sex workers – it hasn’t done so for years. The trade has been dispersed farther south because of police sweeps and gentrification, according to the center’s community assessment study.
For that reason, the LESHRC is now seeking to expand its program to turf in other West Village neighborhoods, targeting transgender prostitutes and homeless youth who inject hormones and are at risk for contracting blood-born diseases like HIV and Hepatitis C.
In late July, Community Board 3 unanimously voted to support a resolution that would permit the center to amend its waiver from the New York State AIDS Institute of the Department of Health to conduct “peer delivered” syringe exchanges via Friday night walkabouts in the 10014 zip code — primarily on Christopher Street starting at 7th Avenue South and extending to the West Side Highway.
But LESHRC may find fewer subjects for its services these days. Prostitution in the West Village has declined considerably in the last five years, according to Martin Baranski, the Sixth Precinct’s Community Affairs Officer – partly because undercover cops dressed as sex workers regularly bust johns. “We also have help from the Parks Department and mounted police on the weekends,” he told Bedford + Bowery. “The neighborhood has also changed. You now have these million-dollar condos.”
David Poster, longtime president of the Christopher Street Patrol, also claims transgender sex workers are rarely seen these days on Christopher Street. He cites a stepped-up police presence as well as the work of his own group, started in 1990 by a block association whose members asked the Guardian Angels to join them on neighborhood watches.
During a recent Friday night patrol with four members of the Angels, he pointed toward Weehawken Street near the pier. “Look at this block–it’s practically deserted,” he said. “There used to be 100 prostitutes a night here.”
Others in the community would welcome LESHRC intervention, among them Robert Zeigler, owner of Boots and Saddle, a popular gay bar that offers drag shows. Zeigler says the scene outside his door “is a little bit better” these days than it was three years ago, but he’s careful to note: “There are still trannie prostitutes and still needles around.” Not long ago, he got stuck with a needle while picking up debris outside his bar and had to be put on anti-AIDS medication for two months – at the cost of $2,000 – just to make sure he wasn’t infected.
Across the street from Boots and Saddle, St. John’s Lutheran Church draws homeless LGBT youth to free meals, counseling and a drop-in program run by New Alternatives, a group that used to operate in the East Village with the Middle Collegiate Church.
Mark Erson, the openly gay pastor at St. John’s, says that every morning when he walks his dog around 5:30 a.m., he sees “kids sitting outside. We get kids from New Jersey, we get kids from the Bronx and Brooklyn. A number of clients, because they are LGBT, are homeless. They’ve been kicked out of their homes. So we do our best not to leave them on the streets. Some are straight kids who need food. Are drugs involved? Yeah. Are some engaged in sex work? Yeah. But they need food and they need to be taken care of. It’s a bigger problem than going after a Nancy Reagan ‘Just Say No’ kind of solution.”
Eric, 27, and Ya Ya, 23, a married transgender couple from Queens who live in a shelter, were wed in the church last September. Several of their friends, they said, have contracted HIV by engaging in sex work or using IV drugs. “Some don’t know what to do when they get it and they go crazy—they say ‘God, what shall I do? Maybe I should kill myself,’” said Ya Ya. “Some don’t know what they have and they do commit suicide. Somebody needs to show them how to deal with it.”
The Harm Reduction Center is trying to do just that. Supported by funds from the state, the city, and a variety of private donors such as the Robin Hood Foundation, it offers a wide range of free services such as HIV testing, medical and mental health counseling and holistic therapies like Reiki, yoga and acupuncture.
“Acupuncture helps people under stress–especially when they stop using,” Smith explained. He characterized his agency’s approach as “non-judgmental. But we do offer alternatives so people don’t stay addicted to drugs.”
In addition, addicts who enroll in the center get a card identifying them as participants, which could keep them out of jail. “If the police stop them, there’s a number on the back of the card that they can call and it’s routed to this agency,” said Sadat Iqbal, director of the center’s syringe exchange and outreach services.
Possession of a syringe is still a Class A misdemeanor in New York State’s penal code. But there are inconsistencies with others statutes. In 2000, the state’s public health law was changed to permit people over 18 to purchase needles at pharmacies without a prescription.
In addition, New York State Assembly Speaker Sheldon Silver and Chelsea Assemblyman Richard Gottfried – who describes SEPs as “life-saving programs” – successfully sponsored a 2010 law that says police can’t arrest individuals who possess a hypodermic needle with drug residue if they are participants in a needle exchange program. “The fact you have a minuscule amount of drugs on your needle doesn’t constitute possession of drugs,” Gottfried said.
But Baranski, at the Sixth Precinct, believed that IV drug users could be arrested “if they’re caught with a hypodermic needle” and do not have a card identifying them as SEP members.
A central premise behind the Harm Reduction Center is that those drug users who don’t feel the need to stop “are going to use one way or another,” said Iqbal, noting that users don’t always know what they’re putting in their bodies. “We’re providing a safer way to do it and that’s how we create a bridge to other services.”
Iqbal described his team’s exchange process as “a very intimate experience. For many people, drugs are something that they hide from a lot of people in their lives. From the first minute we meet them, they’re opening up about it. Over time we built trust with these people. And one day you’ll see a participant say, ‘I really need to stop.’”
Iqbal is leading the SEP’s West Village expansion. Getting approval from the AIDS Institute is a complicated procedure and not likely to be a slam dunk. First, the center must pass muster with Community Board 2 and the Sixth Precinct and also prove its program for transgender sex workers and others does not duplicate existing services, a knowledgeable source said.
Although New York SEPs have drawn opposition from politicians like former Mayor Rudolph Giuliani and local community boards who feared they might spur increased drug use, these days needle exchanges are, for the most part, accepted worldwide by health groups like the American Medical Association and the World Health Organization, said Allan Clear, executive director of the Harm Reduction Coalition on West 27th Street and a member of the New York Commission on AIDS.
“If there’s any opposition at all, it’s from the Republicans,” he added, noting that in 2009 President Obama signed a bill to remove a longstanding ban on federal funding for needle exchanges, but Republicans voted to restore the ban, prompting outrage from gay activists.
Poster, too, was concerned about the prospect of a syringe exchange program coming into the neighborhood he patrols, noting he feared participants might foster a return to the bad old days when boisterous LGBT kids from New Jersey and the outer boroughs created bedlam on the streets and took over the pier. “I don’t know how the residents would feel about that,” he said. “I don’t want to encourage anything that would make it like it once was here. It was horrendous. We don’t want to encourage more prostitutes, more unruly behavior.”